A case of anomalous connection of the pancreaticobiliary ducts observed by peroral cholangiopancreatoscopy (PCPS)

In a patient with non-dilated type anomalous connection of the pancreaticobiliary ducts (ACPBD), we were able to observe the lumens of common channel, bile duct and pancreatic duct by POPS. The patient was a 31-year-old woman with a chief complaint of epigastric pain. Ultrasonography revealed gallstones and gallbladder wall thickening. Drip infusion cholangiography disclosed spindle-shaped dilatation which is often found in case of ACPBD at the terminal portion of the bile duct. The patient was admitted to our hospital because of a suspicion of ACPBD. Endoscopic ultrasonography and endoscopic retrograde cholangio-pancreatography allowed a diagnosis of non-dilated type ACPBD. She was accompanied by gallstones and gallbladder adenomyomatosis, too. PCPS showed the opening of a pancreatic duct branch on the wall of a common channel. It also visualized cholesterosis in the bile duct and no abnormal findings in the pancreatic duct. PCPS was found to be useful in diagnosing minute lesions in case of ACPBD.